Abstract
Noninvasive ventilation (NIV) represents the standard of care for patients with exacerbation of chronic obstructive pulmonary disease. However, NIV fails in almost 40% of the most severe forms of acute hypercapnic respiratory failure and patients must undergo endotracheal intubation and invasive ventilation. Such transition from NIV to invasive ventilation is associated to increased mortality. Under these circumstances, patients may express a clear intention not to be intubated.
Highlights
Noninvasive ventilation (NIV) represents the standard of care for patients with exacerbation of chronic obstructive pulmonary disease
NIV fails in almost 40% of the most severe forms of acute hypercapnic respiratory failure and patients must undergo endotracheal intubation and invasive ventilation
We reported data from a case series of 30 patients with acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease, who refused endotracheal intubation after failing NIV and were treated with extracorporeal Co2 removal plus NIV as last resort therapy
Summary
To assess efficacy and safety of noninvasive ventilationplus-extracorporeal Co2 removal in patients who fail NIV and refuse endotracheal intubation
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